[Question #13348] Retest After Symptoms

1 days ago

Follow up to #12849.

I ended up testing for GC/CT on the 7th day following this exposure with a negative result. Since then, I have been experiencing symptoms that have concerned me and have been spiraling with test accuracy information, false negative potential, etc. My questions:

1) Is the urine NAAT for men conclusive at 7 days? The window period appears to be 7-21 days. I was on the early side. Is it a "probably" accurate, or more definitive and trust it 100%?

2) My symptoms have been post-urinary discomfort which feels like burning/general discomfort in the urethra, but also accompanied with the same discomfort around the groin, perineum, etc. There is no discomfort while urinating (just after, maybe beginning a minute later) or upon ejaculation. I have never experienced any discharge. I also know that the onset of these symptoms is quite late as it has now been almost 5 months since this exposure. I can't recall exactly, but they likely started 3 months or so after the incident. Finally, it is not consistently there each time I urinate, but enough to get my attention.

3) Do I need to retest? What are the statistical odds the original negative result was false? I have had sex with my wife once since then thinking the negative test was to be trusted, so the concern is escalated.

Thank you

Edward W. Hook M.D.

1 days ago

Welcome back to the forum, if you are the same person who posted questions 12489 using a different user name and email address. Are you the same person. Using different identifiers makes our job much mor difficult. Question 12849 regarded a low risk exposure by a man who was subsequently worried and wondered about testing. It is now more than 3 months since that interaction making me wonder why your concerns have lingered. With that as context, I'll go on and answer the current questions:

1) Is the urine NAAT for men conclusive at 7 days? The window period appears to be 7-21 days. I was on the early side. Is it a "probably" accurate, or more definitive and trust it 100%?

I'm not sure where you are getting your information. NAAT tests for gonorrhea and chlamydia are some of the most reliable tests in all of medicine and provide conclusive results any time more than 3-5 days following an exposure. Results at 7 days would be close to 100% reliable.

2) My symptoms have been post-urinary discomfort which feels like burning/general discomfort in the urethra, but also accompanied with the same discomfort around the groin, perineum, etc. There is no discomfort while urinating (just after, maybe beginning a minute later) or upon ejaculation. I have never experienced any discharge. I also know that the onset of these symptoms is quite late as it has now been almost 5 months since this exposure. I can't recall exactly, but they likely started 3 months or so after the incident. Finally, it is not consistently there each time I urinate, but enough to get my attention.

These are not symptoms of STI. Further STI symptoms do not come and go. On occasion, when persons worry about STI, they tend to look for symptoms and as a result, notice otherwise normal sensations which would normally be overlooked. Perhaps this is what is going on for you. Whatever is happening is certainly not an STI.

Testing is always a personal decision. There is close to no chance that your test results are incorrect. If you choose to re-test, I am confident the tests will once again show that you are not infected . I remain confident that your wife is not at risk from your casual encounter months ago.

I hope this information is helpful and reassuring. EWH

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1 days ago

Yes, I likely used a different email in a panic. I'm sorry about that. The exposure was unprotected sex m/f with me in my upper 40's and female upper 50's; One evening, 2 episodes.

Your comments are reassuring, thank you. Just to clarify before I go:

1) Stinging/burning/or otherwise discomfort post-urination is NOT an sti symptom? I can get behind the psychological component for sure, but it's unsettling to have that feeling in the penis and tip and of course leads to fear of infection.

2) "Close to 100% reliable" and "close to no chance" is terminology essentially meaning science is never 100%, not that you're saying there is still a chance at false negative, correct? I know this is a question of semantics but I just want to be sure that's what you meant. I just stumbled across a remark you made on another post about never seeing someone test negative at 3 days only to come back and test positive later. I assume that remains true today?

Thanks again, that is all.

Edward W. Hook M.D.

1 days ago

These are repetitive questions. I'm not sure why you would think the answers would change.

1. Correct.

2. I have no concerns about a falsely negative test.

One follow up remaining. EWH

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